77 articles - From Saturday Mar 19 2022 to Friday Mar 25 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Gastrointest Endosc |
| J Hepatol |
EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. The prevention and management of bleeding and thrombosis in patients with cirrhosis poses several difficult clinical questions. These Clinical Practice Guidelines have been developed to provide practical guidance on debated topics, including current views on haemostasis in liver disease, controversy regarding the need to correct thrombocytopenia and abnormalities in the coagulation system in patients undergoing invasive procedures, and the need for thromboprophylaxis in hospitalised patients with haemostatic abnormalities. Multiple recommendations in this document are based on interventions that the panel feels are not useful, even though widely applied in clinical practice. |
meta-analyses and systematic reviews
| J Crohns Colitis |
Systematic review: The impact and importance of body composition in Inflammatory Bowel Disease. Patients with IBD have alterations in body composition parameters in active disease and clinical remission. The impacts of body composition on disease outcome and therapy are broad and require further investigation. The augmentation of body composition parameters in the clinical setting has the potential to improve IBD outcomes in the future. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Carvedilol versus endoscopic band ligation for secondary prophylaxis of variceal bleeding-Long-term follow-up of a randomised control trial. Following OVB in cirrhotic patients, carvedilol use is associated with survival benefit, fewer liver-related deaths and fewer hospital admissions with decompensated liver disease. Further studies are needed to validate this finding. |
Comparison of clinical prediction rules for ruling out cirrhosis in nonalcoholic fatty liver disease (NAFLD). This cross-sectional analysis of large, multicentre international datasets shows that current clinical prediction rules perform well in excluding cirrhosis with appropriately chosen cutoffs. These clinical prediction rules can be used in primary care to identify patients, particularly those who are white, female, and <65, unlikely to have cirrhosis so higher-risk patients maintain access to specialty care. |
Patterns of emergency admission for IBD patients over the last 10 years in Lothian, Scotland: A retrospective prevalent cohort analysis. Despite compounding prevalence and increased biologic use, IBD admission rates are falling. The cause of admission varies with age, with infection the predominant cause in older patients. |
Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID-19: A self-controlled case series study. The increased risks of AKI and ALI associated with intravenous remdesivir treatment for COVID-19 may be due to the underlying SARS-CoV-2 infection. The risks of AKI and ALI were elevated in the pre-exposure period, yet no such increased risks were observed following remdesivir initiation when compared to the pre-exposure period. |
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
Clinical Characteristics and Outcomes of Nonalcoholic Fatty Liver Disease- Associated Hepatocellular Carcinoma In the United States. NAFLD is the leading etiology of HCC among Medicare beneficiaries. Compared to other etiologies, NAFLD was associated with lower HCC surveillance receipt, early-stage detection, and modestly poorer survival. Multi-faceted interventions for improving surveillance uptake are needed to improve prognosis of patients with NAFLD-related HCC. |
Prospective Study Assessing Impact of Ethylene Oxide Sterilization on Endoscopic Ultrasound Image Quality. In this prospective study, expert review and phantom-based testing demonstrated minimal differences in image quality between echoendoscopes reprocessed using HLD versus ETO+HLD over 2 years of clinical use. Further studies are warranted to assess the long-term clinical impact of these findings. In the interim, these results support use of ETO sterilization of EUS instruments if deemed clinically necessary. |
Sleep positional therapy for nocturnal gastroesophageal reflux: a double-blind, randomized, sham-controlled trial. Sleep positional therapy using an electronic wearable device promotes sleeping in the left lateral decubitus position and effectively alleviates nocturnal reflux symptoms compared to sham treatment ( NL8655). |
| Endoscopy |
Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison. Stent dysfunction occurred in 1 |
| Gastroenterology |
Dysplastic recurrence after successful treatment for early Barrett's neoplasia: development and validation of a prediction model. This is the first externally validated model to predict visible dysplastic recurrence after successful endoscopic eradication treatment of BE with dysplasia or early cancer. Upon external validation, our model has good discrimination and calibration. This model can help clinicians and patients to determine a personalized follow-up strategy. |
Regulation of PGC1a downstream of the insulin signaling pathway plays a role in the hepatic proteotoxicity of mutant a1-antitrypsin deficiency variant Z. Transcriptomic studies showed major effects on oxidative-phosphorylation- and autophagy-genes, and significant induction of peroxisome-proliferator-activated-receptor- |
| Gastrointest Endosc |
Prospective comparison study between 19G needle with 0.025-inch guidewire and 22G needle with novel 0.018-inch guidewire during EUS-guided transhepatic biliary drainage (with video). In conclusion, outcomes of using a 22-G needle with a novel 0.018-inch guidewire were comparable to a 19-G needle with a 0.025-inch guidewire, even in the case of insufficient intrahepatic bile duct dilatation. These results require verification in a prospective, randomized trial comparing 22-G and 19-G needles with a larger sample size. |
| Gut |
Over-the-scope-clips versus standard treatment in high-risk patients with acute non-variceal upper gastrointestinal bleeding: a randomised controlled trial (STING-2). OTSC therapy appears to be superior to standard treatment with clips when used by trained physicians for selected cases of primary therapy of NVUGIB with high risk of rebleeding. Further studies are necessary with regards to patient selection to identify subgroups benefiting most from OTSC haemostasis. |
| Hepatology |
Association between social determinants of health and rates of liver transplantation in individuals with cirrhosis. and relevance This information highlights an urgent need to evaluate how SDOH influence rates of LT with the overarching goal to develop strategies to overcome inequalities. |
Hepatic Kinome Atlas: An In-Depth Identification of Kinase Pathways in Liver Fibrosis of Humans and Rodents. We compared the fibrotic events over four models: humans with cirrhosis and three murine models with differing levels of fibrosis, including two models of fatty liver disease with emerging fibrosis. The data demonstrate a high concordance between human and rodent hepatic kinome signaling that focalizes, as shown by our network analysis of detrimental pathways. Our findings here establish the first comprehensive kinase atlas for liver fibrosis, which identifies analogous signaling events conserved among humans and rodents. |
Loss of Sam50 in hepatocytes induces cardiolipin-dependent mitochondrial membrane remodeling to trigger mtDNA release and liver injury. Physiologically, acetaminophen (APAP, an effective antipyretic and analgesic)-caused Sam50 reduction or Sam50 liver-specific knockout induces mtDNA release, leading to activation of the cGAS-STING pathway and liver inflammation in mice. Moreover, exogenous expression of Sam50 remarkably attenuates APAP-induced liver hepatoxicity. Thus, our findings uncover the critical role of Sam50 in maintaining mitochondrial membrane integrity and mtDNA stability in hepatocytes, and reveal that Sam50 depletion-induced cardiolipin externalization is a new signal of mtDNA release and controls mtDNA-dependent innate immunity. |
PLK4 inhibitor, CFI-400945, suppresses liver cancer through cell cycle perturbation and eliciting anti-tumor immunity. Here we show that by targeting a centrosome regulator, PLK4, to activate the cytosolic DNA sensing-mediated immune response, CFI-400945 effectively restrained tumor progression through cell cycle inhibition and inducing anti-tumor immunity to achieve a durable suppressive effect even in late-staged mouse HCC. |
Preliminary evidence of safety and tolerability of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma and Child-Pugh A and B cirrhosis: a real-world study. This study confirms reproducible safety and efficacy of AtezoBev in routine practice. CP-B patients reported similar tolerability compared to CP-A, warranting prospective evaluation of AtezoBev in this treatment-deprived population. |
Protection and Antibody Levels 35 Years after Primary Series with Hepatitis B Vaccine and Response to a Booster Dose. Based on anti-HBs level =10 mIU/ml at 35 years and a 73.7% booster dose response, we estimate 86% of participants had evidence of protection 35 years later. Booster doses are not needed in the general population at this time. |
| Inflamm Bowel Dis |
Influence and Implications of the Molecular Paradigm of Nitric Oxide Underlying Inflammatory Reactions of the Gastrointestinal Tract of Dog: A Major Hallmark of Inflammatory Bowel Disease. This review is a unique compilation of the role of NO in the pathogenesis of inflammatory bowel disease of dogs. Nitric oxide plays a key role in modulating cancer in the gastrointestinal tract. This review seeks to explore the characteristics of NO as a major hallmark of canine inflammatory bowel diseases. |
Mechanoscopy: A Novel Device and Procedure for in vivo Detection of Chronic Colitis in Mice. Using a colitis mouse model, we demonstrated that GSI positively correlates with the extent of gut fibrosis, the severity of mucosal damage, and the infiltration of immune cells. Furthermore, a critical strain value is suggested, and GSI efficiently detects pathological gut fibrotic stiffening when the strain exceeds this value. Based on these results, we envision that mechanoscopy and GSI will facilitate the clinical diagnosis of IBD. |
National Prevalence of Psychological Distress and Use of Mental Health Care in Inflammatory Bowel Disease. Many of these individuals find the cost of mental health care unaffordable, struggle to find a health provider, and experience repeated emergency room visits. Ongoing efforts to improve mental health care in IBD should address issues of access and cost. Additionally, these efforts should seek to understand other barriers to mental health-care use. |
Psychological Factors Associated With Adherence to Oral Treatment in Ulcerative Colitis. In the multivariable analysis, younger patients, those with a lower perceived competence, and those with worse relationship with their providers were more likely to have lower adherence to their medications. Poor adherence to oral medications in UC was associated with lower perceived competence and worse relationship with providers. Further interventions based on the SDT can potentially improve adherence and optimize patient care. |
| J Crohns Colitis |
A specific calprotectin neo-epitope (CPa9-HNE) in serum from inflammatory bowel disease patients is associated with neutrophil activity and endoscopic severity. Serum CPa9-HNE levels were highly associated with CD and UC patients. CPa9-HNE correlated with the SES-CD score and the full Mayo score, indicating a strong association with disease activity. |
Favourable tolerability and drug survival of tioguanine versus methotrexate after failure of conventional thiopurines in Crohn's disease. We observed a higher cumulative discontinuation incidence due to adverse events for methotrexate (44%), compared to tioguanine (17%) in Crohn's disease patients after failure of conventional thiopurines. The total adverse events incidence during methotrexate use was higher, while serious adverse events incidence was similar. These favourable results for tioguanine treatment may guide the selection of immunosuppressive therapy after failure of conventional thiopurines. |
Pharmacokinetics, Safety, and Efficacy of Intravenous Vedolizumab in Paediatric Patients with Ulcerative Colitis or Crohn's Disease: Results from the Phase 2 HUBBLE Study. Vedolizumab exposure increased in an approximate dose-proportional manner. No clear dose-response relationship was observed in this limited cohort. No new safety signals were identified. |
Temporal changes in the histology of microscopic colitis. The analysis confirms the synchronous occurrence of MC and IBD and transitions between the two diagnoses. In patients who fail therapy for either one of the two diseases, the gastroenterologist should search for changes in the underlying phenotype as a possible explanation. |
| Neurogastroenterol Motil |
Distinguishing the contributions of neuronal and mucosal serotonin in the regulation of colonic motility. We demonstrate that mucosal 5-HT release plays an important role in distension-evoked colonic motility, and that SERT inhibition no longer alters gut motility when EC cells are absent, thus demonstrating that ENS 5-HT does not play a role in regulating gut motility. |
Effect of colonic distension on small bowel motility measured by jejunal high-resolution manometry. Long retrograde reflexes induced by colonic distension distort the balance between segmental and propagated activity, and may affect the normal response of the jejunum to food ingestion. Jejunal manometry in patients may be artifacted by colonic overload. |
Irritable bowel syndrome patients who are not likely to respond to fecal microbiota transplantation. We concluded that IBS patients who are male and/or have low fecal Alistipes levels are most likely to not respond to FMT treatment. Whether low fecal Alistipes levels could be used as a marker for predicting the outcome of FMT remains to be determined. (NCT03822299). |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Lynch Syndrome-a mechanistic and clinical management update. As genetic testing becomes more widespread, the number of individuals identified with LS is expected to increase in the population. Understanding the pathogenesis of LS informs current strategies for detection and clinical management, and also guides future areas for clinical innovation. Unravelling the mechanisms by which these tumours evolve may help to more precisely tailor management by the gene involved. |
Review article: paradoxical psoriasis as a consequence of tumour necrosis factor antagonists in patients with inflammatory bowel disease. The approach to paradoxical psoriasis in IBD should be discussed with a multidisciplinary team to optimise and preserve intestinal disease remission and to ensure the resolution of debilitating skin lesions. |
| Clin Gastroenterol Hepatol |
The Impact of the Social Determinants of Health on Disparities in Inflammatory Bowel Disease. The incidence of inflammatory bowel disease (IBD) is rising in racial and ethnic minority groups in the United States, and socioeconomic, racial, and ethnic disparities in IBD are increasingly being identified. In addition, there has been great appreciation for the social determinants of health (SDOH) as contributors to these disparities, and that upstream SDOH propagate downstream poor health outcomes in IBD. We propose strategies to achieve health equity in IBD that target the medical trainee, provider, practice, community, industry, and policy levels. |
| Hepatology |
| Neurogastroenterol Motil |
Mast cell mediation of visceral sensation and permeability in irritable bowel syndrome. Enteric microbiome interactions including increased mucosal bacterial translocation may activate mast cells to elicit inflammatory responses underlying some of these pathogenic effects. Therapies to alter mast cell activity (mast cell stabilizers) or function (histamine antagonists) have shown modest benefits in IBS. Future investigations will seek to define patient subsets with greater potential to respond to therapies that address visceral hypersensitivity, epithelial permeability defects, and microbiome alterations secondary to mast cell dysfunction in IBS. |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Inflamm Bowel Dis |
| J Hepatol |